Tai chi a possible alternative to aerobic exercise for fibromyalgia

medwireNews: Patients with fibromyalgia can achieve similar or greater symptom improvements with tai chi mind–body treatment as with aerobic exercise, researchers report.

“Our investigation also showed that a longer duration of tai chi results in greater benefits, and patients are more likely to attend tai chi classes,” note Chenchen Wang (Tufts University School of Medicine, Boston, Massachusetts, USA) and fellow investigators.

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The 151 patients who were randomly assigned to one of four classic Yang style supervised tai chi sessions – once or twice a week for 12 or 24 weeks – had a greater improvement in revised fibromyalgia impact questionnaire (FIQR) scores at 24 weeks than did the 75 patients randomly assigned to supervised aerobic exercise twice a week for 24 weeks.

The difference in average FIQR score between the tai chi participants combined and those participating in aerobic exercise was a significant 5.5 points.

While this difference was not deemed clinically significant, based on an estimated minimal difference of 8.1 points, when tai chi was compared with aerobic exercise of matched intensity – twice weekly for 24 weeks – the difference in average FIQR points was a significant 16.2 points.

Indeed, average FIQR scores improved significantly more in the patients doing tai chi for 24 weeks than among those doing it for 12 weeks, with a significant difference of 9.6 points at 24 weeks. The frequency – once compared with twice a week – did not have a significant effect, however.

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The researchers note in The BMJ that participants attending tai chi classes completed 62% of possible classes, which was more than the 40% attended by patients participating in aerobic exercise.

“Tai chi, which consists of a gentler, low impact meditative sequence of movements with minimal side effects, may be better embraced by patients with fibromyalgia in the long term,” they suggest.

The benefits of tai chi were not just limited to reduced fibromyalgia symptoms, the researchers point out, significant differences compared with aerobic exercise were also seen at 24 weeks for patient’s global assessment, anxiety, self-efficacy, and coping strategies.

And the combined tai chi group continued to show greater improvement in most outcomes at 52 weeks, compared with patients participating in aerobic exercise.

“By improving psychological wellbeing, coping, and self efficacy, tai chi mind-body exercise may help to bolster the confidence of patients with fibromyalgia to engage in behaviors that help them manage their symptoms and to persist in those behaviors. Tai chi might also help buffer the negative impact of fibromyalgia symptoms on the patient's physical and psychosocial wellbeing,” the team explains.

They add that by addressing both the physical and psychological effects of chronic pain, tai chi “could be particularly effective in targeting opioid use and misuse,” noting that the reduction in analgesic use over time was similar across the tai chi and aerobic exercise groups.